Permanent Tooth Agenesis and Associated Dental Anomalies among Orthodontically Treated Children.

(1) Background: Tooth agenesis is one of the most common developmental dental anomalies often affecting the maxillary incisors area and premolar regions. (2) Purpose: The aim of this study was to assess the prevalence and distribution of permanent tooth agenesis and the associated dental abnormalities among orthodontically treated children. (3) Materials and Methods: This study was carried out utilizing 3000 pretreatment records of children who underwent orthodontic treatment, 1780 (59%) females and 1220 (41%) males, aged 10-25 years (mean age 15 years). Tooth agenesis and other dental anomalies were surveyed using their panoramic radiographs, according to gender, pattern, and location. The level of statistical significance was set at p < 0.05 using t-test or Chi-Square tests. (4) Results: The total number of missing teeth, excluding third molars, was 518 (17%) found in 326 (11%) children. The majority were the maxillary lateral incisors, which was 176 teeth (34%) (p < 0.05). Of them, 111 (63%) were in females, and 65 (37%) were in males. The second most common missing tooth was mandibular second premolars, which was 137 teeth (26%), followed by missing 73 (14%) maxillary second premolars. Impacted teeth had the highest associated dental anomaly prevalence (14.3%), while transposition showed the lowest anomaly prevalence (0.5%). (5) Conclusions: A prevalence of 11% for tooth agenesis was detected in this study. More teeth were missing in the maxilla compare with the mandible. A significant association was found between missing maxillary lateral incisors and missing premolars (p < 0.05). Associated dental anomalies included an increased number of peg-shaped maxillary lateral incisors, palatally displaced and impacted maxillary canines, ectopic teeth, and infra-occluded (submerged) primary second molars.

Dental Anomalies' Characteristics.

The aim of this study was to characterize dental anomalies. The pretreatment records (photographs and radiographs) of 2897 patients (41.4% males and 58.6% females) were utilized to detect dental anomalies. The dental anomalies studied were related to number, size and shape, position, and eruption. A Chi-square test was carried out to detect associations between dental anomalies, jaw, and sex. A total of 1041 (36%) of the subjects manifested at least one dental anomaly. The prevalence of all dental anomalies was jaw-dependent and greater in the maxilla, except for submerged and transmigrated teeth. The most frequently missing teeth were the maxillary lateral incisor (62.3%) and the mandibular second premolars (60.6%). The most frequent supernumerary teeth were the incisors in the maxilla (97%) and the first premolars in the mandible (43%). Dental anomalies are more frequent in the maxilla and mainly involve the anterior teeth; in the mandible, however, it is the posterior teeth. These differences can be attributed to the evolutionary history of the jaws and their diverse development patterns.

Canine Transposition - Prevalence, Distribution and Treatment Considerations among Orthodontic Patients.

Tooth transposition is a relatively rare dental anomaly of interchange in position of two adjacent teeth. AIM: To determine the prevalence and distribution of canine transposition in a sample of orthodontic patients and present treatment alternatives and outcome. STUDY DESIGN: The records of 3000 consecutively treated orthodontic patients from a university clinic were surveyed to detect canine transposition in both dental arches. The data was recorded according to gender, age, number and location. RESULTS: Canine transpositions were detected in 15 subjects, 3 (20%) males and 12 (80%) females presenting a prevalence of 0.5%. Of them, 6 were between the maxillary canine and first premolar, 7 between the maxillary canine and lateral incisor, 2 transpositions were between the mandibular canine and the lateral incisor. A female to male ratio of 4:1 with left side predominance was found. Treatment options include extracting the transposed teeth, maintaining them in their transposed position, or repositioning them in their normal place within the dental arch. CONCLUSION: The prevalence of canine transposition in the present sample was found to be 0.5% with a greater frequency in the maxilla. Treatment options include extraction of one of the transposed teeth, alignment of the teeth in their transposed position or correction of the anomaly. The latter gives the best esthetic outcome.

Prevalence and Characteristics of Supernumerary Teeth in Israeli Orthodontic Patients.

BACKGROUND: Supernumerary teeth are one of the most common anomalies in the human dentition, found most frequently in the maxillary anterior region causing impaction or displacement of the adjacent permanent teeth. AIM: The purpose of this retrospective study was to determine the prevalence and characteristics of supernumerary teeth in orthodontically treated patients. STUDY DESIGN: Pre-treatment facial and intraoral photographs, study models, panoramic and periapical radiographs of 3,000 consecutively treated orthodontic patients (mean age 12.2 years) from the Department of Orthodontics Tel Aviv University, were examined to detect supernumerary teeth in both arches. They were recorded according to gender, age, number, location, position and morphology. RESULTS: Thirty-six patients, 22 (61%) males and 14 (39%) females with 50 supernumerary teeth, of which 42 (84%) were found in the maxillary anterior region, and 8 (16%) in the mandible, presenting a prevalence of 1.2%. CONCLUSIONS: A prevalence of 1.2% was found in our study. The most common supernumerary tooth is mesiodens located at the maxillary anterior region. The characteristics of supernumeraries were based on their morphology, location and position. The most frequent complications caused were rotations, displacement and arrested eruption of maxillary incisors.

Nonsyndromic orofacial clefts among Jews and non-Jews born in 13 hospitals in Israel during 1993-2005.

OBJECTIVES: Orofacial clefts are one of the most common birth malformations and represent a significant public health economic expenditure. The purpose of this investigation was to study the epidemiology of orofacial clefts in newborns from 1993 to 2005 in Israel. In addition, a comparison of data from the National Birth Defects Registry (NBDR) and Hospital records will be made. METHODS: A retrospective data review of reports to the Israeli NBDR on infants with orofacial clefts in comparison with records reviewed at 13 major hospitals, accounting for 60% of all births in Israel. RESULTS: Of 1334 newborns found to be with orofacial clefts all over Israel between 1993 and 2005, 1015 were reported to the NBDR and 319 were unreported but retrieved from hospital files. During this period, of the 976 578 live births found in the 13 participating hospitals, there were 866 newborns with orofacial clefts. Of those, 684 (79%) were nonsyndromic orofacial clefts and 182 (21%) had additional syndromes. The prevalence of nonsyndromic orofacial clefts was 7/10 000 live births, lower than reported outside Israel. Only 65% of orofacial clefts retrieved from the 13 hospitals were reported to the NBDR. A significantly higher orofacial cleft prevalence was found among non-Jews than Jews (11 and 6 of 10 000 live births, respectively), (P < .00 001). CL/P was found more frequently than isolated cleft palate (CP). More males had orofacial clefts than females, mostly unilateral with left side predominance. CONCLUSIONS: The prevalence of nonsyndromic orofacial clefts was found to be 7/10 000 live births. The higher orofacial cleft prevalence among non-Jews may be explained by the high prevalence of consanguinity and deprived maternal nutritional status in this population.

Supernumerary Teeth in the Maxillary Anterior Region: The Dilemma of Early Versus Late Surgical Intervention.

Supernumerary teeth are the most common developmental dental anomalies in the maxillary anterior region causing interference to the developing permanent incisors resulting in poor dental and facial esthetics. Two different opinions regarding the timing for surgical removal of the supernumerary teeth are presented. In this case report, three brothers with supernumerary teeth in the maxillary anterior region are presented, their surgical and orthodontic management and outcome are discussed.

Agenesis of Permanent Canines in Orthodontic Patients: Prevalence, Location, Treatment Options and Outcomes.

Purpose: Tooth agenesis is one of the most common anomalies of the human dentition, found most often in the maxillary anterior region and in the mandibular and maxillary premolar regions. Little information is available on the prevalence and distribution of permanent canine agenesis. The purpose of this retrospective study was to evaluate the prevalence and distribution of permanent canine agenesis in orthodontic patients and describe treatment options and outcomes. Methods: The records of 3,000 consecutively treated patients in the Department of Orthodontics, Tel Aviv University, Tel Aviv, Israel were reviewed. The pre-treatment facial and intraoral clinical photographs as well as panoramic and periapical radiographs were used to detect permanent canine agenesis in both dental arches. The data were recorded according to sex, age, number of missing canines, and their location. Results: Twenty-three patients (0.76 percent), nine males (39 percent) and 14 females (61 percent) had 38 congenitally missing canines. Of these, 22 (58 percent) were missing in the maxilla and 16 (42 percent) were missing in the mandible. Conclusions: The overall prevalence of missing permanent canines in our population was 0.76 percent. The female-to-male prevalence ratio was approximately three to two and more canines were missing in the maxilla than in the mandible.

Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations.

Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch.

Fused and Geminated Permanent Maxillary Central Incisors: Prevalence, Treatment Options, and Outcome in Orthodontic Patients.

PURPOSE: Developmental disturbances during tooth formation may cause abnormalities in tooth size and shape, resulting in poor dental and facial esthetics. The purpose of this study was to evaluate the prevalence of fused/geminated teeth in the maxillary anterior region of orthodontically treated patients, and present treatment options and their outcome. METHODS: Pre- and post-treatment facial and intraoral photographs, study models, and panoramic and periapical radiographs of 574 consecutively treated patients (mean age: 13.3 years) from the orthodontic department were examined for the presence of fusion or gemination in the maxillary anterior region. RESULTS: There were eight patients (1.4 percent) with fused/geminated teeth in the maxillary anterior region. CONCLUSIONS: The prevalence found is relatively high compared to previous reports. Esthetic consideration is a determining factor for various treatment alternatives. A multidisciplinary approach is imperative for the successful treatment of these dental abnormalities.

Conservative orthodontic treatment for skeletal open bite associated with amelogenesis imperfecta.

Amelogenesis imperfect (AI) is a hereditary dental condition that affects tooth enamel, resulting in small and discolored teeth, tooth sensitivity, poor esthetics, and anterior open bite associated with severe discrepancy in the vertical relation of the jaws. Treatment can be complex and includes an interdisciplinary approach involving orthodontics, oral surgery, and restorative therapy. The purpose of this report is to describe the case of a 12-year-old girl with AI and severe open bite who received conservative, non-surgical therapy that led to good functional occlusion and acceptable dental and facial esthetics. A three-year follow-up showed excellent post-treatment stability.

Prevalence of non-syndromic orofacial clefts among Jews and Arabs, by type, site, gender and geography: a multi-center study in Israel.

BACKGROUND: Orofacial clefts are the most common craniofacial congenital malformations, with significant anatomic, ethnic, racial and gender differences. OBJECTIVES: To investigate the prevalence, distribution and characteristic features of various types of non-syndromic clefts among Israeli Jews and Arabs. METHODS: We conducted a retrospective multi-center survey in 13 major hospitals in Israel for the period 1993-2005. To obtain the true prevalence and detailed clinical characteristics, data on liveborn infants with non-syndromic clefts were obtained from the Ministry of Health's National Birth Defect Registry and completed by chart reviews in the 13 surveyed hospitals. RESULTS: Of 976,578 liveborn infants, 684 presented unilateral or bilateral clefts, with a prevalence of 7.00/10,000 live births; 479 were Jews and 205 were Arabs. The prevalence was higher among Arabs compared to Jews (11.12 and 6.22 per 10,000 live births in Arabs and Jews, respectively, P 0.00001). Males had higher cleft rates than females (7.69/10,000 and 6.17/10,000 live births, respectively, P = 0.05). Males had more cleft lips (P < 0.05) and cleft lips with cleft palate (P < 0.001). There was left-side predominance. Newborns of younger mothers (age < 20 years) and of older mothers (age ≥ 45 years) had higher cleft rates than those with mothers in the 20-44 year bracket (P < 0.009). Children born at or above the 5th birth order had a higher cleft rate (P < 0.001). CONCLUSIONS: The prevalence of non-syndromic clefts was 7.00/10,000 live births. The markedly higher rate in Arabs is related to the high rate of consanguinity. Both very young and old maternal age represents a higher risk of clefts in their offspring.

Mandibular second molar impaction. Part I: Genetic traits and characteristics.

INTRODUCTION: Detection of mandibular second molar (MM2) impaction is imperative for orthodontic diagnosis and treatment. In this study, we examined a possible genetic trait in MM2 impaction in 2 populations and defined distinctive characteristics. METHODS: Initial panoramic radiographs of patients of Israeli (n = 3500) and Chinese-American (n = 3000) origin, aged 11 to 15 years, were examined. Twelve distinctive characteristics were compared between the unilateral impacted and the nonimpacted sides. RESULTS: A total of 120 subjects with MM2 impaction were found (1.8%). The Chinese-American population had a higher prevalence (n = 71, 2.3%) of MM2 impaction compared with the Israeli population (n = 49, 1.4%; P = 0.004). For the subjects with MM2 impaction, the Israelis had significantly (P = 0.039) fewer bilateral impactions (27%) than did the Chinese-Americans (45%). Mesially inclined impacted MM2s were more common (88% and 89%) in the Israeli and Chinese-American populations, respectively. The unilateral impacted side demonstrated reductions in the distance between the mandibular first molar and the ramus (P <0.001), the length of the mesial root of the MM2 (P <0.001), and the height between the MM2 and the mandibular third molar, and increases in the angulations of the MM2 (P <0.001) and the mandibular third molar (P <0.003). CONCLUSIONS: An autosomal genetic trait is present in MM2 impaction with greater penetrance in the Chinese-American population. Within developmental impediments, the deficient mesial root length of the MM2 is the primary impaction factor.

Rootless eruption of a mandibular permanent canine.

The purpose of this article was to describe the rootless eruption of a mandibular permanent canine in a 10-year-old boy; his mandible had been fractured in a car accident. The fracture was at the region of the developing canine, resulting in arrested root formation and causing abnormal, rootless eruption. Current theories on tooth eruption and the important role of the dental follicle in the process of eruption are discussed.

Unusual intraosseous transmigration of a palatally impacted canine.

Intraosseous migration of impacted teeth across the midline to the opposite side of the jaw is a rare dental anomaly of unknown etiology. Transmigration of an impacted mandibular canine through the symphysis to the contralateral side of the arch has been documented. Transmigration of an impacted maxillary canine across the midpalatal suture to the opposite side of the maxilla has not been previously observed and is reported here for the first time.

Early detection and prevention of mandibular tooth transposition.

Distal migration of the mandibular permanent lateral incisor happens rarely and it can be discovered radiographically in the early mixed dentition. If unattended, the tooth may erupt ectopically, usually distal to its normal anatomical position and occlusal to the developing first premolar, and it can become transposed with the permanent canine. Early detection and immediate interceptive removal of the retained deciduous lateral incisor and canine, followed by uprighting the ectopic lateral incisor to its normal anatomical position in the arch, will intercept the problem and prevent the developing transposition.

Intrabony migration of impacted teeth.

Intrabony migration of impacted teeth is a rare dental anomaly, which occurs only in the permanent dentition of the lower jaw. The teeth involved in this phenomenon are the mandibular lateral incisor, canine, and second premolar. Migration of the lateral incisor is usually in a distal direction, resulting in transposition with the canine. Migration of the canine is most frequently in a mesial direction, resulting in transmigration across the mandibular symphysis to the opposite side of the dental arch. The second premolar most often migrates distally, sometimes past the gonial angle and as far as the coronoid process. Surgical and orthodontic treatment options are presented for the three intrabony migrating teeth.